Video polysomnographic analysis of elevated EMG activity and rapid eye movements before abnormal behaviors in REM sleep behavior disorder

Mondo Yoshizawa; Yoshiyuki Tamura; Asami Yasuda-Ohata; Shinsuke Yoshihara; Hideki Takasaki; Sadayuki Hashioka

doi:10.1007/s41105-023-00472-2

Video polysomnographic analysis of elevated EMG activity and rapid eye movements before abnormal behaviors in REM sleep behavior disorder

Sleep Biol Rhythms. 2023 Jul 5;21(4):455-460. doi: 10.1007/s41105-023-00472-2. eCollection 2023 Oct.

Authors

Mondo Yoshizawa¹, Yoshiyuki Tamura¹, Asami Yasuda-Ohata¹, Shinsuke Yoshihara¹, Hideki Takasaki¹, Sadayuki Hashioka¹

Affiliation

¹ Department of Psychiatry, School of Medicine, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510 Japan.

PMID: 38476183
PMCID: PMC10899964 (available on 2024-07-05)
DOI: 10.1007/s41105-023-00472-2

Abstract

The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is unclear. According to the cortical hypothesis, severe RBD episode (RBDE) occurs when spinal motoneurons are less inhibited and cortical and limbic systems are more active. We made this study to prove the hypothesis for the development of RBDE using video-polysomnography (VPSG). VPSG records of 35 patients with RBD were analyzed. According to severity, RBDEs were classified into three motor events (MEs): ME 1; small movements or jerks, ME 2; proximal movements including violent behavior, and ME 3; axial movements including bed falls. For each ME, we measured the number of MEs preceded or not preceded by both REM sleep without atonia (RWA) and REMs during the 10-s-period immediately before ME onset. In severe RBDE (ME 3), the number of MEs preceded by both RWA and REMs was significantly higher than that of MEs not preceded by both (0.8 vs. 0.2, P = 0.033). This was not the case for mild RBDE (ME 1) and moderate RBDE (ME 2). Our results suggest that both RWA and REMs are associated with the development of severe RBDE.

Keywords: REM sleep without atonia; Rapid eye movement sleep behavior disorder; Rapid eye movements; Video-polysomnography.

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